I was surprised to get the illustrated award in the mail some time ago. I didn't know anybody actually ever read this article. Of course, I don't know exactly what it means to be "most cited" -- you mean relative to the usual average of your adviser, your mother, and your spouse reading your articles? (My co-blogger Laura Freschi reassured me that she had never heard that I had written such an article.) Anyway, the answer to the title question of the article What did structural adjustment adjust? was -- contrary to conventional wisdom -- not much, as far as policy changes in the 80s and 90s. Macroeconomic policies did get better in many countries (according to the mainstream academic consensus of what's "better"), but these improvements were unrelated to the intensity of World Bank/IMF "Structural Adjustment Loans."
The World Bank and IMF seem to have achieved the worst of both worlds -- they were blamed for forcing policy conditions on unwilling governments, without actually succeeding at enforcing those conditions. It even led to a xenophobic populist backlash in some Latin American countries. The Fund and the Bank tried to reverse this public relations disaster in the new millennium by retitling the loans Cute Puppies and Adorable Children Poverty Reduction Growth Facilities, but I think they were lastingly tarnished.